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Determining the Impact of Swallowing Impairment in People recovering from Severe COVID-19 Infection

确定吞咽障碍对从严重 COVID-19 感染中恢复的人的影响

基本信息

批准号：
10163657
负责人：
Catriona Margaret Steele
金额：
$ 13.5万
依托单位：
UNIVERSITY HEALTH NETWORK
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-06-01 至 2022-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10163657
关键词：
Acoustics Acute Adult Adult Respiratory Distress Syndrome Ambulatory Care Facilities Aspirate substance Brain Injuries Brain Stem Breathing COVID-19 Caring Cervical spine Cessation of life Chronic Chronic Obstructive Airway Disease Clinic Clinical Collection Communities Coughing Critical Illness Data Deglutition Deglutition Disorders Dependence Development Disease Marker Elderly Esthesia Exhalation Foundations Functional disorder Grant Health Hospitalization Hour Impairment Incontinence Individual Infection Inpatients Intensive Care International Intervention Intratracheal Intubation Intubation Investigation Larynx Length of Stay Liquid substance Measures Mechanical ventilation Medical Muscle Myopathy Nature Nervous System Trauma Neurodegenerative Disorders Normal Range Outcome Patient Outcomes Assessments Patients Pattern Pharmaceutical Preparations Pharyngeal structure Physiological Physiology Pneumonia Population Positioning Attribute Prevalence Property Protocols documentation Reference Values Regulation Rehabilitation therapy Reporting Research Respiration Risk Risk Factors Self Care Signal Transduction Site Smell Perception Spine surgery Stethoscopes Stroke Taste Perception Testing United States National Institutes of Health Urinary tract infection Variant Work acute care base case history constriction cost deconditioning digital experience falls follow-up high risk hospital readmission implementation strategy improved malignant oropharynx neoplasm mortality muscle strength novel oral care pandemic disease programs respiratory standard of care

项目摘要

Project Summary/Abstract The recent spread of COVID-19 has led to an international pandemic, with >4 million confirmed cases to date worldwide, of which >1.3 million confirmed cases and >80,000 deaths have been reported in the USA. Infected individuals commonly experience severe respiratory difficulties and pneumonia, leading to hospital admission and the need for intensive care and mechanical ventilation. Emerging evidence suggests that impaired taste and smell may be early markers of the disease, and that in severe cases, there may be neurological damage in in the medulla, an important brainstem control site for both respiration and swallowing. Given the overlapping neuroanatomical regulation of breathing and swallowing, we hypothesize that dysphagia (swallowing impairment) will be common in People recovering from Severe COVID-19 (PrSC-19) and associated with poorer outcomes. Through this grant supplement, we propose to extend our existing work characterizing dysphagia profiles in different clinical populations to study dysphagia and its impact in PrSC- 19. To understand the prevalence and pathophysiology of dysphagia in PrSC-19, we will conduct detailed analyses of videofluoroscopies performed during the standard of care, post-discharge from intensive care to regular medical care units within the acute care setting. Given the current limitations in performing swallowing assessments for inpatients who test positive for COVID-19, we will also establish 3 regional research clinics that will offer comprehensive swallowing assessments to PrSC-19 after discharge from acute care to rehabilitation or the community. These assessments will include the collection of case history information, videofluoroscopy, use of a novel digital stethoscope to measure respiratory-swallow coordination, measures of other risk factors for dysphagia (e.g. bulbar muscle strength) and patient-reported outcomes. Detailed analyses of the videofluoroscopies will identify specific measures of swallowing that fall outside the range of normal variation based on comparison to healthy reference values established through our research program exploring swallowing physiology on liquids of different consistencies.

项目概要/摘要最近的 COVID-19 传播已导致一场国际大流行，迄今为止确诊病例已超过 400 万例全球范围内，其中美国报告了超过 130 万例确诊病例和超过 8 万例死亡。已感染个人通常会出现严重的呼吸困难和肺炎，导致入院以及需要重症监护和机械通气。新的证据表明味觉受损和气味可能是这种疾病的早期标志，在严重的情况下，可能会出现神经损伤延髓是呼吸和吞咽的重要脑干控制部位。鉴于呼吸和吞咽的神经解剖学调节重叠，我们假设吞咽困难（吞咽障碍）在重症 COVID-19 (PrSC-19) 康复者中很常见，并且与较差的结果相关。通过这笔赠款补充，我们建议扩展我们现有的工作表征不同临床人群的吞咽困难概况，以研究吞咽困难及其对 PrSC-的影响 19. 为了了解 PrSC-19 中吞咽困难的患病率和病理生理学，我们将进行详细的研究在标准护理期间、出院后从重症监护室到急症护理机构内的常规医疗护理单位。鉴于目前执行方面的限制为了对 COVID-19 检测呈阳性的住院患者进行吞咽评估，我们还将建立 3 个区域研究诊所将为 PrSC-19 急性出院后提供全面的吞咽评估关心康复或社区。这些评估将包括收集病例历史信息、视频透视、使用新型数字听诊器测量呼吸吞咽协调性、吞咽困难其他危险因素的测量（例如延髓肌力量）和患者报告结果。对视频荧光检查的详细分析将确定秋季吞咽的具体措施根据与通过建立的健康参考值的比较，超出正常变化范围我们的研究项目探索不同稠度液体的吞咽生理学。